Individual provider Active NPI

Daniel Lee Trumbull, PA-C

  • Physician Assistant
  • Toledo, OH
National Provider Identifier
1356841480
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005487RX Issued in OH
Practice address
2121 Hughes Dr Ste 710
Toledo, OH 43606-3845
Phone
(419) 291-2671
Fax
(419) 291-2680
NPI assigned
Feb 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005487RX OH Primary

Addresses

Primary practice location

2121 Hughes Dr Ste 710
Toledo, OH 43606-3845

Mailing address

5638 Kirkland Rd
Toledo, OH 43615-1938
Phone (419) 262-1893

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address daniel.trumbull.p1@direct.whc.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319001783 OH Practitioner - Physician Assistant 7911269584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wood Health Company LLCGroup PAC ID 7911800461, 61 clinicians

Practice addresses (Care Compare)

141 N Keyser Ave
Deshler, OH 43516-1111
Phone (419) 278-2065

950 W Wooster St
Bowling Green, OH 43402-2603

960 W Wooster
Suite 216
Bowling Green, OH 43402-2650
Phone (419) 354-3123

960 W Wooster St
Bowling Green, OH 43402-2650

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005487RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Oct 1, 2019 Accepting new patients
Promedica Central Physicians Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients

Locations

2121 Hughes Dr
Ste 710
Toledo, OH 43606
Phone (419) 291-2610

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1356841480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 KIRKLAND RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151938",
            "telephone_number": "419-262-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HUGHES DR STE 710",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063845",
            "telephone_number": "419-291-2671",
            "fax_number": "419-291-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMBULL",
        "first_name": "DANIEL",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005487RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "daniel.trumbull.p1@direct.whc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "960 W Wooster St Ste 204",
            "city": "Bowling Green",
            "state": "OH",
            "country_code": "US",
            "postal_code": "434022650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.